lOMoARcPSD|3760051
ob-newborn-86pg-study-guide-contains-comprehensive-summary-of-the-new-
information-found-in-the
OB Newborn 86pg - Study guide contains
comprehensive summary of the new information
found in the
Concepts Of Maternal-Child Nursing And Families (Nova Southeastern
University)
Downloaded by Yingyi
,StuDocu is not sponsored or endorsed by any college or university
Downloaded by Yingyi
, lOMoARcPSD|3760051
The Physiological Responses of the Newborn to Birth
Respiratory Adaptations
- The newborn period is the time from birth through the 28th days of life. During
this period, the newborn adjusts from intrauterine to extrauterine life.
- The first few hours of life, in which the newborn stabilizes respiratory functioning
and circulatory functions are called neonatal transition.
- To begin life as a separate being, the baby must immediately establish respiratory
functioning and ventilation (come out the vagina crying). Know that the main
systems to check when they’re born are Respiratory first then cardiovascular, and
finally thermoregulation transition to extrauterine life! The most important things to
do so the baby breathes correctly are: cutting the cord, SUCTIONING, touching
them, and newborn must have adequate surfactant levels
Intrauterine Factors Supporting Respiratory Function
- Adequate fetal lung development allows the newborn to expand the lungs
and exchange oxygen and carbon dioxide gases
Fetal Lung Development
- During the first 20 weeks’ gestation, development is limited to the differentiation
of pulmonary, vascular, and lymphatic structures. From 20 to 28 weeks, alveolar
ducts begin to appear, followed by primitive alveoli. During this time, the alveolar
epithelial cells begin to differentiate into type I cells (structures necessary for gas
exchange) and type two cells (structures that provide synthesis and storage of
surfactant).
- Surfactant, a lipoprotein that coats the inner surfaces of the alveoli is composed of
surface-active phospholipids (lecithin and sphingomyelin), which are critical for
alveolar stability. Develops at 28-32 weeks. Surfactant peaks at about 35 weeks’
gestation and remains high until term, paralleling late fetal lung development. At
this time, the lungs are developed enough to permit maintenance of lung expansion
and adequate gas exchange, although fetus may need to go the NICU.
- AT: Surfactant when taking a deep breath in alveoli expands and when breathing out
contract, if not enough surfactant when breathing out alveoli collapse . Always assess
amount of surfactant by LS ratio (2:1) normal means that baby can breathe in the
outside world. Late in the pregnancy when they perform an amniocentesis they are
1
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, lOMoARcPSD|3760051
looking for the LS ration that indicates lung maturity. If LS ration is less baby will have
respiratory distress.
- Clinically, the peak production of lecithin-one component of surfactant-
corresponds closely to the marked decreases in the incidence of respiratory
distress syndrome for babies born after 35-week gestation.
- The newborn born before the lecithin/sphingomyelin (L/S) ratio is 2:1 will
have varying decrease of respiratory distress syndrome.
Fetal Breathing Movements
- The newborn’s ability to breathe air immediately after birth appears to result
from fetal breathing movements (FBM), the intrauterine practice respiratory
movements that begin around the 17th to 20th week gestation.
- These breathing movements are essential for developing the chest wall
muscles and the diaphragm, and for regulating lung fluid volume and
resultant lung growth.
Initiation of Breathing
- To maintain life, the lungs must function immediately after birth. Two radical
changes must take place for the lung to function:
o Pulmonary Ventilation must be established through lung expansion following
birth
o A marked increase in the pulmonary circulation must occur
- NOTE: mechanical-fetal chest, chemical (asphyxia), thermal, and sensory
(touch, auditory, verbal) help initiate the first breathe
Mechanical and Re-Absorptive Process
- In preparation for the birth, lung fluid production normally decreases and
fetal breathing movement decreases 24 to 36 hours before the onset of true
labor
- Excess fluid must be removed from alveolar spaces after birth for effective gas
exchange to occur. During vaginal birthing process, a thoracic squeeze occurs and
squeezes a small amount of fluid out of the lungs. Process of labor is responsible for
the initial movement of lung fluid out of the lungs. If the baby doesn’t experience labor,
then the infant has an increase chance of getting transient tachypnea. C-section babies
are at higher risk for RDS and come out blue because they don’t get the thoracic
squeeze that occurs in a vaginal birth.
- The high positive intra-thoracic pressure distributes the inspired air throughout
the alveoli and begins to establish functional residual capacity (FRC), the air left
Downloaded by Yingyi
()
ob-newborn-86pg-study-guide-contains-comprehensive-summary-of-the-new-
information-found-in-the
OB Newborn 86pg - Study guide contains
comprehensive summary of the new information
found in the
Concepts Of Maternal-Child Nursing And Families (Nova Southeastern
University)
Downloaded by Yingyi
,StuDocu is not sponsored or endorsed by any college or university
Downloaded by Yingyi
, lOMoARcPSD|3760051
The Physiological Responses of the Newborn to Birth
Respiratory Adaptations
- The newborn period is the time from birth through the 28th days of life. During
this period, the newborn adjusts from intrauterine to extrauterine life.
- The first few hours of life, in which the newborn stabilizes respiratory functioning
and circulatory functions are called neonatal transition.
- To begin life as a separate being, the baby must immediately establish respiratory
functioning and ventilation (come out the vagina crying). Know that the main
systems to check when they’re born are Respiratory first then cardiovascular, and
finally thermoregulation transition to extrauterine life! The most important things to
do so the baby breathes correctly are: cutting the cord, SUCTIONING, touching
them, and newborn must have adequate surfactant levels
Intrauterine Factors Supporting Respiratory Function
- Adequate fetal lung development allows the newborn to expand the lungs
and exchange oxygen and carbon dioxide gases
Fetal Lung Development
- During the first 20 weeks’ gestation, development is limited to the differentiation
of pulmonary, vascular, and lymphatic structures. From 20 to 28 weeks, alveolar
ducts begin to appear, followed by primitive alveoli. During this time, the alveolar
epithelial cells begin to differentiate into type I cells (structures necessary for gas
exchange) and type two cells (structures that provide synthesis and storage of
surfactant).
- Surfactant, a lipoprotein that coats the inner surfaces of the alveoli is composed of
surface-active phospholipids (lecithin and sphingomyelin), which are critical for
alveolar stability. Develops at 28-32 weeks. Surfactant peaks at about 35 weeks’
gestation and remains high until term, paralleling late fetal lung development. At
this time, the lungs are developed enough to permit maintenance of lung expansion
and adequate gas exchange, although fetus may need to go the NICU.
- AT: Surfactant when taking a deep breath in alveoli expands and when breathing out
contract, if not enough surfactant when breathing out alveoli collapse . Always assess
amount of surfactant by LS ratio (2:1) normal means that baby can breathe in the
outside world. Late in the pregnancy when they perform an amniocentesis they are
1
Downloaded by Yingyi
()
, lOMoARcPSD|3760051
looking for the LS ration that indicates lung maturity. If LS ration is less baby will have
respiratory distress.
- Clinically, the peak production of lecithin-one component of surfactant-
corresponds closely to the marked decreases in the incidence of respiratory
distress syndrome for babies born after 35-week gestation.
- The newborn born before the lecithin/sphingomyelin (L/S) ratio is 2:1 will
have varying decrease of respiratory distress syndrome.
Fetal Breathing Movements
- The newborn’s ability to breathe air immediately after birth appears to result
from fetal breathing movements (FBM), the intrauterine practice respiratory
movements that begin around the 17th to 20th week gestation.
- These breathing movements are essential for developing the chest wall
muscles and the diaphragm, and for regulating lung fluid volume and
resultant lung growth.
Initiation of Breathing
- To maintain life, the lungs must function immediately after birth. Two radical
changes must take place for the lung to function:
o Pulmonary Ventilation must be established through lung expansion following
birth
o A marked increase in the pulmonary circulation must occur
- NOTE: mechanical-fetal chest, chemical (asphyxia), thermal, and sensory
(touch, auditory, verbal) help initiate the first breathe
Mechanical and Re-Absorptive Process
- In preparation for the birth, lung fluid production normally decreases and
fetal breathing movement decreases 24 to 36 hours before the onset of true
labor
- Excess fluid must be removed from alveolar spaces after birth for effective gas
exchange to occur. During vaginal birthing process, a thoracic squeeze occurs and
squeezes a small amount of fluid out of the lungs. Process of labor is responsible for
the initial movement of lung fluid out of the lungs. If the baby doesn’t experience labor,
then the infant has an increase chance of getting transient tachypnea. C-section babies
are at higher risk for RDS and come out blue because they don’t get the thoracic
squeeze that occurs in a vaginal birth.
- The high positive intra-thoracic pressure distributes the inspired air throughout
the alveoli and begins to establish functional residual capacity (FRC), the air left
Downloaded by Yingyi
()
